Patients Report High Satisfaction with Sex-Reassignment Surgery

Male-to-female sex-reassignment surgery had high satisfaction rates among a group of German patients with gender dysphoria, new research reports.

Most of the respondents said they would have the surgery again and would recommend it to other transgender individuals.

Sex-reassignment surgery is usually one component of a gender transition, which may also include psychotherapy, hormone therapy, and a period of real-life experience as the desired gender.

Male-to-female sex-reassignment surgery typically includes vaginoplasty – the creation of a vagina. Some surgeons use penile skin for this process, but the study authors noted some problems with this approach, such as stricture (narrowing), and necrosis (tissue cell death). Patients may also find that their new vagina is not long or deep enough.

With these factors in mind, the authors designed their own surgical technique, and this study aimed to assess patients’ quality of life afterward.

Forty-seven transwomen who had undergone surgery between 2007 and 2013 responded to a specially-designed questionnaire. The participants ranged in age from 18 to 57, with an average age of 38 years. An average of 19 months had passed between the patients’ last surgery and the questionnaire. (Some patients had had correction surgery following their sex-reassignment surgery.)

About half of the participants lived alone; 62% were single. Fifteen percent were married, but the authors suggested that this low amount (compared to past studies) reflected the participants’ relatively young mean age.

The questionnaire included items regarding satisfaction with surgical outcomes, femininity, and quality of life that were developed by the research team. It also included a German-language questionnaire called the Fragen zur Lebenszufriedenheit (FLZ, translated as “Questions on Life Satisfaction”). This assessment contained modules on general life satisfaction, satisfaction with health, and satisfaction with body image.

Post-surgical satisfaction was high. Ninety-one percent of the respondents said they would “most certainly” have the surgery again; the remaining participants said they would be “very likely” to do so. None of them regretted the procedure, and 89% said they would recommend it to others. The majority (96%) of the respondents were living as full-time women.

Scores on the FLZ life satisfaction assessment were compared to scores from a similar group of cisgender women (without gender dysphoria). Participants generally scored “significantly lower” than the comparison group on general life satisfaction, a finding that the authors suggested, “could point to transsexuals’ problems with their identity and coping with life, which is ongoing even after [sex-reassignment surgery] (especially family life and living conditions).” They called for further research on the social aspects of gender transition.

Scores for the health satisfaction module were not significantly different. For the body image module, the transwomen had increased satisfaction with their breasts and genitals.

“[The study’s] findings and the largely positive satisfaction with the esthetic outcome might show that our combined technique is a possible option for [male-to-female] transsexuals seeking surgical intervention,” the authors wrote.

The study was published online in March in the Journal of Sexual Medicine.


The Journal of Sexual Medicine

Papadopulos, Nikolaos A., MD, PhD, FACS, et al.
“Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery”
(Full-text. (Published online: March 30, 2017)